Provider Demographics
NPI:1184792731
Name:HARBOR CHIROPRACTIC CENTER INC. P.S.
Entity type:Organization
Organization Name:HARBOR CHIROPRACTIC CENTER INC. P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:360-533-2630
Mailing Address - Street 1:2555 SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:HOQUIAM
Mailing Address - State:WA
Mailing Address - Zip Code:98550
Mailing Address - Country:US
Mailing Address - Phone:360-533-2630
Mailing Address - Fax:360-533-1608
Practice Address - Street 1:2555 SUMNER AVE
Practice Address - Street 2:
Practice Address - City:HOQUIAM
Practice Address - State:WA
Practice Address - Zip Code:98550
Practice Address - Country:US
Practice Address - Phone:360-533-2630
Practice Address - Fax:360-533-1608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0001409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACAB34008Medicare ID - Type Unspecified